The clinical research of retroperitoneal laparoscopic nephron sparing surgery with hypothermic renal artery perfusion in situ

Objective Development of a new retroperitoneal laparoscopic technology which can keep the kidney in cold ischemia and has the characteristics of safety,effective and simplicity.Methods Twenty two patients who needs to do the retroperitoneal laparoscopic nephron sparing suygery were divided into two groups.In research group,we did the retroperitoneal laparoscopic nephron sparing surgery with hypothermic renal artery perfusion in situ.In the control group,we did the same as well except the renal hypothermia.Compared with the renal temperature and the rectal temperature during the surgery,and the glomerular filtration rate (GFR) of both bilateral kidney and affected side kidney before and after the surgery.Results All the surgery were done successfully in the patients of both groups.And no post-operative bleeding,inflammation and leakage of urine was found.In the research group,the average Cold ischemia time was (47.2 ±3.8) min,the average minimum renal temperature was (17.73 ±0.91) ℃.In the research group,the average value of affected side kidney GFR was (30.57 ± 4.07) ml/min before the surgery ; the average value of affected side kidney GFR was (20.92 ± 4.49) ml/min 1 month after the surgery.In the control group,the average value of affected side kidney GFR was (30.65 ± 5.45) ml/min before the surgery; the average value of affected side kidney GFR was (17.90 ± 3.50) ml/min 1 month after the surgery.The follow-up time was 1-16 months without local recurrence and metastasis.Conclusion We found that our new equipment with circumfusion system of ice saline can keep the kidney in cold ischemia,it was easy-to-use and efficient. Key words: Laparoscopy;  Partial nephretomy;  Cold ischemia